Annexure I

                                                 Application for the Study Grant

                                (For Visiting Libraries to Collect Material for Research)

1.

Name:                                                                                           Passport Photo

  2.

Mailing Address (With Pin code):

E-mail Id:                                          Fax:                                             Phone: 

3.

Date of Birth:                                            Category:                   General/ OBC/ ST/ SC 

4.

Educational Record:

Examination   University      1Year1 Class15Marks(%)1 1Subjects 1Rank(if any)

5.

(a) Date of Registration of Ph.D:

(b) University / Institution of Registration :

(c) Name and Designation of  the Supervisor/Guide:

6.

Approved Research Theme:

7.

Libraries to be Visited (name  and address):

(i)

(ii)

(iii)

8.

Duration of the Proposed Visit: 111111111111 11111From: 11111111toTo:

9.

Whether the Centre(s)/Libraries have agreed to provide facilities for work:  Yes / Not yet

(if yes, please attach copy of the letter from the Head of the Centre/Library)

10.

Details of the Study Grant  awarded  by any of the ICSSR in past 3 years.

11.

Details of financial assistance applied for / received from the ICSSR under other schemes 

 such as Fellowships, Contingency Grants, etc. 

12.

Details of financial assistance applied for / being received from agencies other than ICSSR,

such as Universities, U.G.C. etc. in last three years.

13.

I Hereby Declare That :

I have read the rules governing the scheme and shall abide by them.

I am  at present not getting any financial assistance from the ICSSR, University, U.G.C.

or from any other agency for the purpose of the intended visit.

The material required by me is not available in the libraries of the city / town where

 I am residing / working.

I have / have not been previously awarded a Study Grant by the ICSSR.

The information given in the form is true and correct.

In the event of any information being found to be false, the application may not be considered.

Date :

                        Signature of Applicant

Certificate of the Registrar of the University / Head of the Institution/Department.

(i)

*Shri/Shrimati/Kumari ……………………………………… is registered for Ph.D. at ………………………

for the topic mentioned in this application. The date of registration is ……………………….

and the name of his/her Supervisor / Guide is……………………………………………………..

(ii)

The application of Shri/Shrimati/Kumari ………………………………………………. Is forwarded

 for consideration. It is certified that the information given in the application

 has been found to be correct.

                                                           Signature of the Registrar/Head of the Institution/Department

(With Rubber Stamp)

* Starred item relates only to Ph.D. scholars

Note

The application for Study Grant will be considered only if it is accompanied by the

 following documents for consideration :

(i)

Detailed elaboration of the Research Proposal : scope, objectives and the methodology, etc.

(ii)

Progress of the work already done on the Research Proposal (with recommendation

of Supervisor / Guide in case of Ph.D. scholars).

(iii)

True copy of the Registration Certificate for Ph.D.

(iv)

List of publications to be consulted.

 (v)

In case Study Grant has been accepted previously by any of the ICSSR centres,

please also enclose a detailed report of the work (duly approved by the Supervisor)

accomplished during the Study Grant.

(vi)

Any other information which the scholar may like to give in support of the application.